The importance of rotatory proofs in the evaluation of a dizzy patient

In order to obtain an adequate functional evaluation of the vestibular system, we have to take into account the results of as well the caloric as the rotary tests. The discordance obtained in some cases, where a complete bilateral caloric areflexia is present whereas a conserved reactivity is confirmed by the rotationstimulus, argues against the merely application of the caloric stimulus. The opposite data obtained by both tests provide us information necessary to a good understanding of the functional state of our dizzy patient. Those cases where an unilateral hypo- or areflexia is detected by the calorics, may prove to be either "compensated" or not at the rotary stimulus. This functional datum is very important, as it informs us about the "Regulations-funktion", the central vestibular processing. Even in some cases only the rotary proof may indicate a dysequillibrium, which constitutes an objectivation of the dizzy state of our patient. The caloric DP, though it is a similar dysequilibrium, cannot substitute the rotary DP, this imbalance being of the same nature but not identical. We confirm and illustrate these argumentations by the statements in a series of 513 patients examined by a complex rotatory stimulationscheme.